cefoperazone

Classification

Indications

Treatment of the following infections caused by susceptible organisms:

Skin and skin structure infections,

Urinary tract infections,

Gynecological infections including gonorrhea,

Respiratory tract infections,

Intra-abdominal infections,

Septicemia.

Action

Binds to the bacterial cell wall membrane, causing cell death.

Therapeutic effects

Bactericidal action against susceptible bacteria.

Similar to that of second-generation cephalosporins, but activity against staphylococci is less, while activity against gram-negative pathogens is greater, even for organisms resistant to first- and second-generation agents.Notable is increased action against:

Citrobacter,

Enterobacter,

Haemophilus influenzae,

Escherichia coli,

Klebsiella pneumoniae,

Morganella morganii,

Neisseria gonorrhoeae,

Proteus,

Providencia,

Pseudomonas aeruginosa,

Serratia.

Has some activity against enterococci.Has some activity against anaerobes, includingBacteroides fragilis.

Central nervous system

Gastrointestinal

Dermatologic

Hematologic

Local

pain at IM site (most frequent)

phlebitis at IV site (most frequent)

Miscellaneous

allergic reactions including anaphylaxis (life-threatening)

superinfection

Interactions

Drug-Drug interaction

Ingestion of alcohol within 48–72 hr of cefoperazone may result in a disulfiram-like reaction.May potentiate the effects of anticoagulants and ↑ risk of bleeding.Concurrent use of loop diuretics or aminoglycosides may ↑ risk of nephrotoxicity.

Availability (generic available)

Nursing implications

Nursing assessment

Assess for infection (vital signs; appearance of wound, sputum, urine, and stool; WBC) at beginning of and throughout therapy.

Before initiating therapy, obtain a history to determine previous use of and reactions to penicillins or cephalosporins. Persons with a negative history of penicillin sensitivity may still have an allergic response.

Obtain specimens for culture and sensitivity before initiating therapy. First dose may be given before receiving results.

Observe patient for signs and symptoms of anaphylaxis (rash, pruritus, laryngeal edema, wheezing). Discontinue the drug and notify health care professional immediately if these symptoms occur. Keep epinephrine, an antihistamine, and resuscitation equipment close by in the event of an anaphylactic reaction.

Monitor bowel function. Diarrhea, abdominal cramping, fever, and bloody stools should be reported to health care professional promptly as a sign of pseudomembranous colitis. May begin up to several weeks following cessation of therapy.

Intravenous Administration

If aminoglycosides are administered concurrently, administer in separate sites, if possible, at least 1 hr apart. If second site is unavailable, flush lines between medications.

Intermittent Infusion: Reconstitute each gram with 5 mL of sterile or bacteriostatic water for injection, 0.9% NaCl, or D5W. Shake vigorously and allow to stand for visualization and clarity. Solution may be colorless to straw-colored. Diluent: Further dilute each gram in 50–100 mL of 0.9% NaCl, D5W, D10W, D5/0.25% NaCl, D5/0.9% NaCl, D5/LR, or lactated Ringer's solution. Solution is stable for 24 hr at room temperature and 5 days if refrigerated.

Patient/Family Teaching

Advise patient to report signs of superinfection (furry overgrowth on the tongue, vaginal itching or discharge, loose or foul-smelling stools) and allergy.

Caution patients that concurrent use of alcohol with cefoperazone may cause a disulfiram-like reaction (abdominal cramps, nausea, vomiting, headache, hypotension, palpitations, dyspnea, tachycardia, sweating, flushing). Alcohol and alcohol-containing medications should be avoided during and for several days after therapy.

Evaluation/Desired Outcomes

Resolution of the signs and symptoms of infection. Length of time for complete resolution depends on the organism and site of infection.

cefoperazone

/cef·o·per·a·zone/ (sef″o-per´ah-zōn) a &#x03B2;–resistant, third-generation cephalosporin effective against a wide range of aerobic and anaerobic gram-positive and gram-negative bacteria; used as the sodium salt.

After enrichment, the tube was again centrifuged, and 100 [micro]L of the sample from each of 49 tubes was streaked onto modified cefoperazone charcoal deoxycholate agar (mCCDA) (blood-free agar base supplemented with CM739 + SR155) (Oxoid).

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